Tuesday_1 Flashcards
Why take prednisone in the morning?
To prevent insomnia
How much grapefruit juice do you have to drink for there to be a drug interaction with atorvastatin
Atorvastatin label states: “7.2 Grapefruit Juice: Contains one or more components that inhibit CYP 3A4 and can increase plasma concentrations of atorvastatin, especially with excessive grapefruit juice consumption (>1.2 liters per day).”
Name 3 ADRs from dulaglutide
Stomach upset; nausea; diarrhea
Who is at risk for CKD?
Those with HTN, CVD, DM, family history. Elderly.
Name 2 ADRs from beta agonists
Tremor, Heart Palpitations, tachycardia
Hypokalemia, if giving high dose continuously. for hyperkalemia use stack nebs or continuous nebs for treatment
What long-acting beta agonist has a short onset of action?
Formoterol is 5min
What is the #1 cause of hyperkalemia?
“#1 cause is AKI in acute setting. 80% excreted through kidneys, so if your kidney’s stop working it will build up
Also common in patients with RAAS agents, ARNi,”
Name some counseling for albuterol inhalers
Bronchioles lack cartilage, so need to be opened
Start breathing slowly, then depress
Hold in lungs for 5-10 seconds
Wait a minute, then do a second puff
Really should wait 5 minutes for the first puff to work
Takes 5 m for initial onset of action; open lungs
Then a second puff will open them further; get down into smaller places in lungs
Who should get started on HTN medications?
above 140 over 90; start two if 20mmHg/10mmHg above goal
What are the symptoms of PAD?
”"”Leg pain – is this PAD? Typical – exertional leg discomfort; calf, foot, thigh that improves with rest. Which level of artery is involved?
Femoral popliteal then have some symptoms or tibial
Thigh, back or hip symptoms – aortal iliac disease
Pseudoclaudication – back pain, shooting pains, but not exertional, classically positional”””
Name 3 points to remember for BP measurement.
First clinic blood pressure is usually high
Measure correctly:
No coffee, exercise for 30m
Sit alone, not chatting or gabbing for 5 minutes
Feet flat on the floor
Arm resting at heart height, back supported
Empty bladder – full bladder can raise 10-15mmHg”””
What is recommended combination of HTN medications for AA?
“ARB/thiazide. AA tend to have low renin HTN, lower efficacy of ACE/ARB without diuretic
Chlorthalidone isn’t in fixed dose combination, nor indapamide”
How do you prevent macrovascular complications in DM?
“Microvascular disease – prevented by glucose control
Macrovascular disease – prevented by controlling HTN, HLD
PAD, strokes, CAD
Glucose is a minor player”
For a patient with DM2 starting on insulin, which medications to stop? Continue?
Stop sitagliptin, Stop SU. Continue GLP1, metformin, pioglitazone
For a DM2 patient with HgbA1c of 8.8 (target 7), what is initial therapy?
For those 1.5% above target – metformin + another agent
